Samuel R Pettis, MD in Seattle, WA - Medicare Internal Medicine

Samuel R Pettis, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Seattle, Washington. His current practice location is 742b Boylston Ave E, Seattle, Washington. You can reach out to his office (for appointments etc.) via phone at (000) 000-0000.

Samuel R Pettis is licensed to practice in Washington (license number MD00017597) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922061191.

Contact Information

	Samuel R Pettis, MD
	742b Boylston Ave E, Seattle, WA 98102-4619
	(000) 000-0000
	Not Available

Map and Direction

Physician's Profile

Full Name	Samuel R Pettis
Gender	Male
Speciality	Internal Medicine - Nephrology
Location	742b Boylston Ave E, Seattle, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1922061191
Provider Enumeration Date: 04/10/2006
Last Update Date: 11/26/2007

Medicare PECOS Information:

PECOS PAC ID: 1658271796
Enrollment ID: I20051212000605

Medical Identifiers

Medical identifiers for Samuel R Pettis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922061191	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RN0300X	Internal Medicine - Nephrology	MD00017597 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel R Pettis allows following entities to bill medicare on his behalf.

Entity Name	Franciscan Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093165334 PECOS PAC ID: 0547173866 Enrollment ID: O20031111000789

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel R Pettis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samuel R Pettis, MD 742b Boylston Ave E, Seattle, WA 98102-4619 Ph: () -	Samuel R Pettis, MD 742b Boylston Ave E, Seattle, WA 98102-4619 Ph: (000) 000-0000

Reviews and Comments

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Vyshak Alva Venur, M.D Nephrology Medicare: Accepting Medicare Assignments Practice Location: 825 Eastlake Ave E, Seattle, WA 98109 Phone: 206-520-5700

Samuel R Pettis, MD - Medicare Internal Medicine in Seattle, WA